Category Archives: Mental Health

Hoarding – Could the brains of hoarders really be different?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Brain

Memory.
Photo courtesy of Pixabay.com

Hoarding is about to become a recognized mental illness.

Hoarders just can’t make decisions when it comes to their own stuff. They don’t have trouble evaluating other people’s things, just their own, according to a study funded by the National Institute of Health.

There has been a lot more publicity about this than in times past but I have to believe that there have always been hoarders. People who lived through the “Great Depression” (1929 not 2008) tended to keep lots of stuff because if you ran out of wire or nails there might not be money to buy more. That is not the sort of saving that gets diagnosed as hoarding.

There seems to be something uniquely different about the way the mind of a hoarder works. Even when outsiders come in and reorganize the place, dispose of the garbage, the problem is not solved. The hoarder faced with new stuff, today’s mail or leftover napkins and condiment packets from fast food, can’t make a decision about what to keep and what to save. The result is they keep everything.

Proposed for inclusion in the new DSM-5 the new “Hoarding Disorder” is a fairly straightforward diagnosis with only a few characteristics needed to make the diagnosis.

The characteristics needed, in my oversimplified explanation of this one are:

1. Can’t bear to throw things away whether they are worth saving or not.

2. They feel like they must keep it and get upset if forced to part with the item.

3. As a result of the hoarding, they run out of room, and can’t use parts of their home for what it should be used for.

4. Hoarding is causing them problems with jobs, friends, making them unhappy, or creating an unsafe situation.

5. No other reason, medical, etc., for this behavior, is found

6. This is not caused by another mental illness like depression or anxiety etc.

Points one to three are what makes this disorder different and points four to six are standard conditions for almost all diagnosis to look for other possibilities and make sure this really is a problem before making the diagnosis.

There appear to be two types of hoarders.

Those who are indiscriminate collectors and go out of their way to get new stuff, buying, stealing, and scavenging things even when they have no use for the item.

Those hoarders who do not go out of their way to get things but can’t figure out what to keep and what to toss after they get things.

Whichever type of hoarder you or a person close to you are, the hoarder needs help. Cleaning out a hoarder’s collection is a short-term temporary fix. Hoarders need help from a profession to change their thinking or the whole process of accumulating just keeps repeating its self.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

m.

Is stress a diagnosable reason for time off from work?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Stress person

Stress.
Photo courtesy of Pixabay.com

Stress and time off from work – Morning Question #18

Short answer – Yes, no, and maybe.

Yes. – Stress is diagnosable – IF the person’s reaction to the stress is extreme and they are unable to work, have relationship problems, or are upset about the way the stress is affecting them. It could be Acute Stress Disorder, Posttraumatic Stress Disorder, or possible an Adjustment Disorder.

No – not everyone who has stress at work should get a diagnosis. Everyone has some stress, even good things like a new job or a promotion can be stressful. So just having stress is not enough for the diagnosis.

Maybe – Maybe you can take stress time off with pay, maybe you won’t get paid for time off.

Time off from work is a legal issue. If you have leave coming or qualify for disability then you might get paid time off. Sometimes a counselor will suggest it would be good for you to take some time off even if you do not qualify for paid time off. Self-employed people probably will not get any paid time off but the counselor may recommend it anyway.

Check the laws in your jurisdiction and the rules for your workplace regarding the issue of the time off being paid.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

6 new Eating Disorder Traits

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Unhealthy food

Unhealthy relationship with food.
Photo courtesy of Pixabay

New eating disorders that did not make the cut.

Update.

The DSM-5 is out now. some of the proposed changes did not happen. The NEC became other specified and unspecified. I have left this post up as it reflects the thinking in the field but for the latest official diagnostic criteria consult the new DSM-5.

Beginning in 2013 when the DSM-V appears the mental health diagnostic landscape will change. We have known for a long time that the current way of understanding Eating Disorders has left out a lot of people who had problems in their relationships with food and weight.

The old way of seeing things, that eating disorders consisted of Anorexia Nervosa and Bulimia just didn’t fit the majority of people who a therapist might see who had problems around food and weight. In some outpatient clinics, more people got the diagnosis of Eating Disorder Not Otherwise Specified (NOS) than got a specific diagnosis. All that is about to change.

One way of cutting down on the overuse of a diagnosis is to just delete it. The Eating Disorder NOS will suffer this fate.

The new label will be Eating Disorder Not Elsewhere Classified (NEC.) The difference will be the creation of 6 new “types” or conditions. This is similar to the way we have been doing Personality Disorder symptoms that are not quite severe enough to be full disorders, we just call them “traits.”

The new conditions, in my order of explanation not the APA’s order, are:

A. Purging disorder

This will require that they purge to lose weight but will not include binging behaviors. This separates Purging Disorder from Bulimia.

B. Night Eating Syndrome

People who do this get upset about it; upset enough to go for treatment so I think this one is an improvement. The current description reminds me of the cravings associated with addiction or impulse control problems.

With Night Eating Syndrome you wake up, you eat and you remember eating. It is not the same as emotional eating. After the night eating, you get upset about this behavior. The episode is not the result of changes in your sleep or eating pattern.

C. Atypical Anorexia Nervosa

In this condition, the person does everything a person with anorexia does but their weight does not drop below the magic 85% of normal. Hope the APA gives us some more to go on here. I can see how separating this from Avoidant Restrictive Food Intake disorder might be confusing.

D. Subthreshold Bulimia Nervosa

Same as Bulimia Nervosa but they don’t do the binging and compensating behaviors as often or for as long. The efforts to compensate for binging are less than once per week and/or last less than 3 months. This reminds me of depression with mild, moderate, and severe categories.

E. Subthreshold Binge Eating Disorder

Like Binge Eating Disorder but not often enough or over a long enough period of time to be sure it is Binge Eating Disorder. The binges are less than once per week and/or last less than 3 months.

F. Other Feeding or Eating Condition Not Otherwise Classified

This is a place to put anything that does not fit another eating diagnosis but needs attention. As a result of all the changes in the DSM-5, new diagnoses, the conditions listed under not otherwise classified, and the inclusion of some childhood things that used to be separated from eating disorders there will be a whole lot less ending up here. Effectively this should empty out all those miscellaneous NOS diagnoses.

Other posts about eating disorders and the new DSM-V proposals will be found at:

Binge Eating Disorder – the other side of Anorexia and Bulimia 

Middle class and starving to death in America – An Eating Disorder called Anorexia

Love-Hate Relationship with food – Bulimia Nervosa

Eating Disorders and Substance abuse  

Avoidant Restrictive Food Intake Disorder

Do any of these eating disorder traits fit you or someone you know?  Feel free to leave a comment. If any problem with weight or eating is affecting your job, relationships, or making you unhappy, consider seeing a professional.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Avoidant Restrictive Food Intake Disorder

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29

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Counseling questions

Counseling questions.
Photo courtesy of Pixabay.com

Avoidant Restrictive Food Intake Disorder vs. Anorexia and Bulimia.

How is Avoidant Restrictive Food Intake Disorder (ARFIDO) different from all those eating disorders people have come to know? And did we really need another eating disorder diagnosis?

Proposed for the new DSM-5 and looking like a for-sure new recognized eating disorder is ARFIDO.  ARFIDO has some differences from past eating disorders. Given the many possible bad relationships with food people could become involved with, my take is yes this one is different from either Anorexia Nervosa or Bulimia and it has been needed for some time.

The way we have been looking at eating disorders has had some flaws for a while now. McFarland et al in 2008 wrote an interesting article on eating disorder relapse. The topic of relapse and relapse prevention has been an important part of substance abuse treatment for a long time. Recently we have been looking at the issue of relapse related to mental health issues.

In his article, McFarland reported that they ended up including all the people with an eating disorder in the relapse study because people with an eating disorder move between disorders often enough to prevent saying someone has one and only one eating disorder.

We also are told in this article that the majority of people in treatment for an eating disorder, up to 60% of those treated in outpatient, did not meet the criteria for one of the official diagnosis and ended up in the leftover category Eating Disorder Not otherwise specified (NOS).

Creating a new disorder (ARFIDO) is supposed to reduce the number of people who were ending up in that vague NOS land.

People with ARFIDO are different from those with anorexia nervosa or bulimia in several important ways. (I have taken liberties with the new DSM-V criteria here for sake of explanation.)

1. They do not have the characteristic distorted body image.

Ask a person with anorexia what they think about their current weight and they will tell you they are fat. Show them their reflection in the mirror, bones sticking out and all and they will still say they look fat. They see themselves at fat and no facts, not even the scale and the standard weight charts, will change that perception.

People with ARFIDO do not necessarily think they are fat.

They know they are thin, abnormally thin, but they like it that way. They become proud of their ability to stay thinner than most. They will keep up the dieting even when they know they are developing a health problem or nutritional deficiency because they like being one of the thin ones.

2. They don’t especially like food, food is the enemy.

People with ARFIDO will avoid many or all foods. They may need to resort to nutritional supplements to keep their weight above the critical go-to-hospital point.

3. They avoid putting on weight as they grow or in adulthood lose excessive amounts of weight.

They will continue avoiding food even when they know they are making themselves sick by their intentional starvation.  Like Pieter Pan, they do not want to grow up or get larger.

4. This is not the result of starvation or lack of resources. People with ARFIDO do this on purpose. The will harm their health to look thin while living in a home with a full refrigerator.

5. Because they are so good at avoiding eating, people with ARFIDO do not have the need for the extreme measures we see in Anorexia Nervosa or Bulimia.

That is my understanding of this new diagnostic category at the current point in time. The new DSM will be out early next year and we can all get the full details then.

The update I read at the APA site was May 14-2012. They also note that when this is all done they expect there to be three subtypes of ARFIDO, A People who do not eat and are not interested in eating B People who will only eat food with certain sensory characteristics,  C People who won’t eat because of an aversive experience.

Other posts about eating disorders and the new DSM-V proposals will be found at:

Binge Eating Disorder – the other side of Anorexia and Bulimia 

Middle class and starving to death in America – An Eating Disorder called Anorexia

Love Hate relationship with food – Bulimia Nervosa

Eating Disorders and Substance abuse  

So do you think that this creation of ARFIDO will improve recognition of poorly recognized eating disorders? Do you believe you or someone you know has had an episode of Avoidant Restrictive Food Intake Disorder? If you recovering from or have you had a relapse to Avoidant Restrictive Food Intake Disorder would you care to leave a comment?

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

DBT Treatment for Borderline Personality Disorder – Dialectic Behavioral Therapy

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11

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

DBT therapy – mindfulness.
Photo courtesy of pixabay.

Does treatment for Borderline Personality Disorder work?

Lots of treatments for Borderline Personality Disorder have been tried over the years. One treatment, Dialectic Behavioral Therapy (DBT) has lots of evidence that it works and is effective.

The problem in treating Borderline Personality Disorder.

Lots of clinicians (Counselors and Therapists) do not use DBT and don’t want to learn it. In fact, plenty of clinicians I know don’t even like seeing BPD clients. Some clients don’t like going for DBT either, despite the glowing testimonials we hear from clients who say DBT changed their life.

If DBT is so effective for treating BPD, why do so few clinicians want to use it and why aren’t their lines of clients waiting for treatment?

BPD is a painful disorder. Treating BPD is like treating a burn victim. They are in terrible pain. Just touching them (emotionally) may cause them to feel the pain. Helpers don’t like to hear their clients scream in pain. Clients in pain tend to lash out. Clients with BPD are more likely than other people to lash out at the therapist, walk out of session, and even go out and try to hurt themselves.

Their pattern of unstable relationships is so pervasive that they have difficulty forming a healthy relationship with the clinician. Just when we think we are helping them they may quit treatment and blame the clinician for their increased pain. They are also more likely to file complaints with the licensing board or even a lawsuit because they feel therapy did not help them and now their pain is even worse.

Despite all these issues DBT does work and does help clients with BPD.

About Dialectic Behavioral Therapy (DBT.)

DBT was developed by Marsha Linehan (Ph.D.) at the University of Washington. Her book Cognitive-Behavioral Treatment of Borderline Personality Disorder is a classic in the field and her workbook has lots of useful exercises for clients to use. I have had the pleasure of hearing Marsha Linehan speak a number of times but can’t say I am fully trained on DBT. What follows is my horrifically oversimplified understanding of what DBT is and how it works.

DBT is a blend of Cognitive Behavioral Therapy, that change your thinking, to change your feelings, to change your behavior stuff that I like to use, and “stuff” Marsha Linehan calls mindfulness. The pain from BPD is so intense that the normal reaction would be to run away.

Mindfulness involves stress reduction, meditation, and ways to be able to reduce and tolerate that pain. By reducing the need to run from pain the pain can be shrunk to a manageable size. This skill is called “distress tolerance.”

Since many clients with BPD (maybe all) came from non-affirming environments they struggle with issues of self-worth and self-acceptance. Clients with the full-blown disorder not just some small level of BPD traits have lots of self-harming and self-destructive behaviors which they use to get away from the negative feelings.

Treating DBT has been described as “like driving a car with one foot on the gas and one on the brake.”  It makes for a bumpy ride for both the clinician and the client.

The client needs to learn to accept and like themselves just the way they are. The clinician continually tells the client that they are a worthwhile human just the way they are.

The client needs to change. They need to stop doing those self-destructive, self-sabotaging behaviors, which are keeping them stuck in an unhappy life. Now comes the tricky part.

When the clinician says “I want you to change” the client hears “I am no good and need to change to be accepted.” The clinician then says “You are accepted just the way you are, but I still want you to change.”

The struggle here is to have clients accept that the goal is not for them to be a certain way to be acceptable, but that what we are looking for is “progress not perfection.”  Any good coach or teacher wants to see their student’s progress and do better, that does not mean there is anything wrong with them if they do not become the best at their discipline.

There is a second challenge for those with BPD and those who treat them which DBT seeks to address.

People who have BPD do not live in the meadow full of flowers in the springtime, they live in the hurricane. If they are ever in a calm place, they know this is the eye of the hurricane and the next blast of the storm is a moment away.

Because the volume on their emotions is turned up so loud, there is always the crisis of the day, hour, or minute. When you are living in an emotional hurricane it is hard to think about disaster preparedness.

The clinician who does DBT has to limit the time they spend on today’s crisis so they can work on developing skills to prevent or cope with future crises. This “let’s not talk about your urges to cut on yourself or use drugs right now, let’s work on your skills” attitude is hard for clinicians and clients who are used to that warm fuzzy empathetic listening stuff.

Clients can leave a skills-based session thinking that the counselor didn’t listen to them and doesn’t care. The counselor may worry “what if they do cut or self-harm? Will it be my fault because I wanted to work on stress reduction skills?” Sticking to the skills-building curriculum can be difficult for both.

One ethical principle that clinicians have learned is that it is not helpful to keep the client dependent on their counselor to cope with life. Our goal should be to get the client to the place where they can function without the clinician. Sometimes that is uncomfortable for both client and counselor.

So DBT is very useful in treating BPD because it increases the client’s self-confidence and self-esteem while teaching them the skills to believe they can cope with life’s problems without having other people do it for them.

Other posts on Borderline Personality Disorder include:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

If any of you have been to someone for Dialectic Behavioral Therapy or have had another treatment for Borderline Personality Disorder, would you be willing to leave a comment and tell us how it worked or didn’t work for you?

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Does a drunk suicidal person go to jail?

Posted on by
6

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Does a drunk suicidal person go to jail?
Picture courtesy of pixabay

When the law, medicine, and mental health intersect.

Sometimes people have more than one problem.

What happens when someone has a medical problem, a psychiatric problem and they break the law? When something interacts with the law the law usually wins. How these cases at the intersection of disciplines are resolved depends on the laws in your jurisdiction. Most places in the United States have similar statutes often based on uniform law statutes. More and more places on earth are recognizing that mental illness is not a choice and that the mentally ill need special consideration in their encounters with the law. Here are some of the possible outcomes of a drunken suicidal person based on what happens here in my jurisdiction.

Partly this depends on the order in which things happen. Do they go to the hospital for a heart attack and then we discover they are drunk and suicidal? Or have they been arrested for driving under the influence first? What if they killed someone while drunk and now are thinking of killing themselves. All very different scenarios.

While I separate medical, psychiatric, and correction issues, some places may have facilities for several of these issues. Hospitals may have psychiatric units, in custody units, and so on.

Crisis issues should always get the first look.

If someone is having a heart attack or bleeding to death they need immediate medical attention. They go to the hospital. If medical problems show up while they are in jail or the psychiatric facility they should be transferred to a medical hospital unless where they are also offered that second service.

Alcohol is one of the most life-threatening of all the drugs from which to detox. People can and do die from alcohol withdrawal. If someone has ever had the Delirium tremens (DTs) they are at risk to die while sobering up. This needs to be supervised by a medical doctor.

If someone is suicidal they need psychiatric care.

We have a procedure here in California for placing someone on a psychiatric hold (technically a request for evaluation) and getting them sent for an evaluation. That first hold is only good for 72 hours. After that, a psychiatrist needs to say they need to stay or they get discharged. If they committed a crime they might get discharged from the psychiatric facility and still face legal charges.

Once at a psychiatric hospital and under the care of a psychiatrist, they will be evaluated and kept until the crisis resolved. The laws have lots of safeguards to keep people from putting other people they don’t like away and keeping them locked up for long periods of time.

Once upon a time – people stayed in psychiatric hospitals for a long time. Stays of several years or even forever commitments were common. Not anymore. Since the advent of effective medications, stays at psychiatric hospitals are getting shorter and shorter.

Stays of a week or less are now common. A long-term stay in the psychiatric facilities I have worked in would now run two weeks to a month.

Killing yourself or attempting to is illegal in most places, only the most rabid law and order types would even consider chasing someone down and arresting them because they had thought about suicide while drunk.

With the intoxicated person, they are likely to change their mind about suicide once they sober up. Studies show that people who are binge drinkers, when they drink they get drunk, are 55 times more likely to attempt suicide than people with no alcohol in their system.

So generally speaking a drunken suicidal person will not be sent to jail. If nothing else the jail does not want people killing themselves while in jail. Having clients die in your facility is bad for a business even if you run a jail or prison.

No jail for the drunken suicidal person – unless –

If the drunken person has committed a serious crime while intoxicated they are still held liable. Being drunken is not an excuse for bad or illegal behavior. Being mentally ill does not, and should not, get you a pass either.

You may not go to prison, but you will have consequences, like time in a hospital for the criminally insane, until we are sure you understand what you did and are capable of not doing that again.

Jails do have psychiatric units and they do have to put people who were arrested for serious crimes on a suicide watch from time to time. But no, most times, they have no interest in arresting and detaining someone who is suicidal.

For the record – people who are placed on a psychiatric hold are not under arrest. This does not result in a police record or mean you will have to say yes to having been convicted of a misdemeanor or felony on a job application. Your psychiatric treatment record is supposed to be confidential just like your medical treatment record. Do not let the fear of legal consequences stop you from calling for psychiatric help if someone is suicidal. Dead people do not worry about having a record.

One consequence of being in the psychiatric hospital will likely be a form you sign at discharge that tells you that you cannot buy or own a firearm for five years after being in a psychiatric hospital. If you want to get a gun, then you will need to appear before a judge and convince him you have a good reason to own one.

But if you are the sort of person who gets drunk and then thinks about killing yourself and others, you are not the kind of person that I would like running around my neighborhood with a weapon.

If someone is medically sick they need to be in a hospital, someone who is suicidal needs psychiatric care, and someone who breaks the law gets arrested. When someone has more than one of these issues we may have trouble figuring out what to do.

Hope that answers the question a reader sent in “Does a drunk suicidal person go to jail?” If you have more questions or comments on the issues of suicide, intoxication, and our society’s response to people with multiple problems please leave a comment.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Lady Diana, Bipolar and Borderline Personality Disorder

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Lady Diana’s headstone.
Photo courtesy pixabay.

Did Lady Diana have Bipolar disorder, Borderline Personality Disorder, or what?

Some interesting questions from reader Gledwood about Bipolar, Borderline Personality Disorder, and Lady Diana. See the comments after Levels or Types of Borderline Personality Disorder.

I never met Lady Diana and am not so much a follower of royalty, so I can’t give you a specific diagnosis about her. In fact, it is considered unprofessional for therapists to give opinions on someone they have not assessed. But maybe I can give you some general answers on these two conditions and on how psychiatric labels may not fit celebrities very well.

1. Borderline Personality Disorder (BPD) and Bipolar are very different conditions.

There may be some small similarities and someone could have both but my thinking is there are quite different conditions.

BPD is like a volcano erupting. Huge uncontrollable emotions. They love you – then they hate you, sometimes the emotions change in the same hour. BPD has a huge pain component. Most people with BPD were abused, molested, or had a non-affirming childhood. People with BPD often self-harm and they do it to relieve the pain not to find pleasure. They have trouble coping with negative emotions and will frantically try to find ways to stop having to feel bad.

Medication may help BPD and so will therapy but it is a slow process.

Bipolar is like a ride through the mountain in a car.

Sometimes down in the valleys in the shade and other times up near the top in the sun. Bipolar also involves some irresponsible impulsive behavior when manic but it is more about impulsive over-seeking of pleasure than anger-driven. The ups and downs happen more slowly and someone with Bipolar can have years of depressed behavior and mouths or years of overactive pressured behavior. Bipolar Disorder often responds to medication. Over-responding to antidepressants is one characteristic that makes us think – Bipolar.

Someone with Bipolar can be trapped by depression for long periods of time and stay stuck there.

Diana Spencer and Lady Diana were probably very different people.

Public figures are often very different in their personal lives than their public lives. The Royals can’t very well hang out at the local bar (or Pub.) Take that press about what someone is like based on their public appearances with a lot of salt. Many comedians and singers are very shy in small groups but once on stage, they can assume a whole other “persona.”

Fans need to be careful to not confuse the person with the character they play. Celebrities have the same problem and start thinking they are their character. There is a difference between being “typecast” and always portraying the villain and those performers who play themselves while on stage. My guess is that having to play the role made it hard for her to maintain old friendships and relationships.

The diagnostic criteria professionals use and the popular meaning of terms are not the same.

I see way too many people who are being called “Bipolar” who are moody, irritable or just plain hard to get along with but they do not necessarily have periods of either depression or mania.

The DSM descriptions are a lot longer than the oversimplified description in most blog posts. There are 11 factors listed for mania and mania is only one factor needed for a diagnosis of Bipolar I Disorder. Professionals need a lot of information before making these decisions.

Symptoms of both these and other disorders are normal traits that get out of control.

Despite the fact that I get paid to treat people with mental illnesses and substance use disorders I think we are trying to turn a lot of normal human emotions into diseases.

Everybody gets sad sometimes. Most of us do impulsive things. If you have never acted on an impulse we think you may have a problem with being obsessive or compulsive. Lots of us get into disagreements and don’t want to be around or talk to others who annoyed us. Someone who has BPD has a pattern of lots of unstable relationships their whole life.

The labels Bipolar and BPD apply to people with severe forms of these conditions; there are a whole lot of other people who have a few characteristics, sort of like one of these conditions. If you have just a few symptoms, counseling or other preventative measures may help you avoid developing a full-blown disease.

Other posts on Borderline Personality Disorder include:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

Hope that helped with the case of Lady Diana, Bipolar, and Borderline Personality Disorder.

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

Levels or types of Borderline Personality Disorder

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65

By David Joel Miller MS, Licensed Therapist & Licensed Counselor.

Are there different types of Borderline Personality Disorder?

personality disorder

Are there types of Borderline Personality Disorder?
Photos courtesy of Pixabay.

People with Borderline Personality Disorder (BPD) differ so much there might be more than one type of BPD or that we may be placing several different mental illnesses together under one label. Gunderson in his book Borderline Personality Disorder describes three levels of functioning in people with BPD. Hotchkiss appears to enlarge this idea into three types of borderlines.

Diagnostic criteria for mental health disorders are largely normal characteristics that have grown so large that they begin to interfere with everyday life. Everyone has sadness sometimes and we all are or should be anxious occasionally. That same concept of degree rather than nature is applicable to BPD.

Masterson wrote about Narcissistic Personality Disorder and described this as coming in low, medium, and high levels. I think the use of that same sort of yardstick for measuring BPD might be useful.

Low Borderline characteristics or traits.

People with low BPD or beginning Borderline traits have or are able to sustain a primary relationship. This relationship may be rocky but the low borderline trait individual is able to have satisfying interactions with a partner. They will perceive this partner as supportive.

What brings a low symptom Borderline into treatment will be feelings of emptiness, loneliness, or depression despite having a supportive partner. They may also suffer from chronic boredom or masochism. They want both a close relationship and fear that relationship because needing someone exposes you to becoming dependent on them.

As a result of the presence of that supportive person in their life, a mild BPD individual may go undiagnosed. They may lack the intense anger and have fewer and milder mood swings than those that appear in more severe cases. Their self-destructive behaviors will be fewer and less frequent and may be ascribed to life experiences like layoffs or fights with their S. O. rather than being recognized as BPD traits.

What tips the clinician off to the BPD traits is not the current relationship but a history of previous unstable relationships and a pattern of over-rapid entry into and speedy exit from relationships, as well as a history of being the victim of abuse or neglect.

Medium BPD.

As the symptoms of BPD become more severe you may experience more anger, more worries about losing your partner, and more frantic efforts to keep your partner in the relationship. People with medium BPD are described as having difficulty seeing things from other’s points of view and devaluing others. They may manipulate as a way to get their needs met. They have the belief that asking will not get them what they need and that they need to force others to stay with them.

This level of borderline functioning is full of break-ups and make-ups, drama from current and previous relationships, and recurrent self-harm or suicide attempts to force the partner to stay. Someone with medium intensity BPD may plan suicide with the thought that this will punish the other for not loving them enough.

High Borderline Personality Symptoms.

When BPD reaches this level the person with Borderline Personality Disorder is unable to maintain a relationship with a significant other. They are without a functioning support system and become increasingly lonely and angry. They may develop distorted thinking, delusions, and eventually hallucinations. They may have episodes of panic involving various anxiety-provoking possibilities.

At this level of BPD symptoms, the most likely coping mechanisms are efforts to distract the self by using drugs and alcohol, abusing food, and acting out behaviors. Fights, promiscuity, self-mutilation, or suicide attempts will be common.

Are relationships a cause or the result of the level of BPD?

There is some question as to whether having a significant relationship reduces the level of borderline traits or if people low in traits can maintain better relationships than those who are high in BPD traits.

One thing that seems clear is that if you have a supportive other in your life, especially in your primary relationship, you are more likely to be able to cope with your mental illness. Learning life skills can improve your functioning and increase the likelihood of finding a supportive partner. Healthy people attract healthy partners.

Are you doing all you can to create good relationships with others and to become the kind of person who can have happy supportive relationships?

Other posts on Borderline Personality Disorder are:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What Causes Borderline Personality Disorder?

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By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

personality disorder

What Causes Borderline Personality Disorder?
Photo courtesy of Pixabay.com

Suggested causes for Borderline Personality Disorder (BPD)

Since this is a condition that is diagnosed by the presence or absence of a group of symptoms rather than any one specific test our understanding continues to change. Some authors have suggested that there are several levels or types of Borderline Personality Disorder. People with milder BPD symptoms can be described as having Borderline traits. It is possible that various levels of BPD symptoms may have different causes.

Like most other mental illnesses, Borderline Personality Disorder (BPD) appears to have both a genetic risk factor and an environmental risk factor. Having a risk factor does not mean that you are going to develop the disorder but the more the risk factors the more the risk.

Genetics is a risk factor for mental illness.

NIMH (National Institute of Mental Health reported some time back (2008,) that there appears to be a genetic risk factor for BPD. This study found that a particular mutation on chromosome nine created an increased risk for BPD. At some point in the human past, the characteristics we think of as Borderline traits may have been helpful in certain situations.

Experience has made any one research report linking a particular chromosome and a disorder highly suspect. It would be nice if this study were correct and we could do a simple test for BPD, but with other disorders, we find that it is not one gene or chromosome that creates mental illness. It is the influences of several or a combination of large numbers of the many possible genes that result in an increased risk.

In this study, the contribution of genetics was 40%. Meaning that the environment contributed the other 60% or put another way, your relationships and experiences increase the risk of developing BPD 150% as much as your genetics.

The environment can increase the risk for Borderline Personality Disorder.

One factor seems to contribute a huge amount of this environmental risk.

Growing up in a non-affirming place with people who did not validate you, is a hugely important cause of many of the symptoms that make up BPD and Borderline Personality traits.

Many people with borderline traits report that their family was not supportive. Their caregivers were either absent or constantly frustrating.

Many people with BPD grew up in homes that did not create the feeling of being valued as a human being. People with BPD may have been neglected, abused, or simply did not have their emotional needs met. They may have found that direct requests for things did not work and that the only way to get their needs met was to engage in behaviors that forced the family to notice them. In adult life, their behaviors will be described as manipulative.

A borderline can be both clingy and distant, wanting a close intimate relationship but also fearful that to let someone get in close to them invites another abandonment.

People with BPD may associate any accomplishment with an increased risk of abandonment. They often quit school a week before finals or fail to show up for a job on the first day.

People with Borderline characteristics may end up slipping into a relationship with someone who has difficulty being close. Just like the co-dependent person who keeps marrying the alcoholic trying to get it right, someone with BPD may continue to enter a relationship with a partner who is unable to provide any warmth and closeness.

The classic expression of this feeling becomes “If I become fully me, will you stop loving me?” The recurring fear is that the significant person in their life will abandon them and they will fall apart without someone to support them.

One issue people with BPD may need to tackle is the inability to have and enjoy happiness or other positive feelings. If you came from an environment that said it was not OK to have or display feelings, it can be terrifying to allow yourself to feel happiness of any sort.

The person with PBD may feel empty, numb, or bored without someone else in their life that provides for their needs. The theory here is that the more the person was let down by their support system, the less able they have been at becoming an independent person, the more likely they will be to develop borderline traits.

Learning to act Borderline.

Those with BPD often come from homes where the caregivers themselves had poorly regulated emotional lives. Parents can and do frequently provide genetic risk factors, environmental factors, and learned behavior that support the continuation of BPD.

Is seems likely that living with or around a caregiver with BPD is likely to alter the way in which someone handles emotion.

The takeaway from all this is that whatever the reason someone has BPD there are treatments available that can help manage, reduce, or eliminate the symptoms of Borderline Personality Disorders.

Other posts on Borderline Personality Disorder include:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel

What is Borderline Personality Disorder?

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25

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

personality disorder

What is borderline personality disorder?
Photo courtesy of Pixabay.com

Bipolar or Borderline Personality Disorder?

People with Borderline Personality Disorder (BPD) experience intense emotional pain and lots of loss in their life. They never feel the faint breeze or the warmth of the sun in the springtime. For the Borderline the world is a place of hurricanes and scorching heat. Life is one horrific storm. They experience terrible loss. BPD may result in interrupted education, ruined or unstable relationships, and frequent job loss.

BPD can look like Bipolar Disorder but while the Bipolar person may have months of depression and long periods of elevated mood or irritability the BPD person has all those mood changes in a single day.

Borderline Personality Disorder (BPD) is an often overlooked and misunderstood mental health issue that gets placed under the heading Personality Disorders. BPD is coded on Axis II and viewed as long-standing and difficult to treat. Personality disorders often co-occur with other mental health challenges such as depression and Bipolar disorder. Because of the notion that a personality disorder is difficult, if not impossible to treat, there is a reluctance to give clients this diagnosis.

Untreated BPD is viewed as a “pervasive” or inflexible pattern in life and includes four characteristics, unstable relationships, fuzzy self-image, impulsivity, and lots of negative emotions. The DSM lists 9 “criteria” or symptoms the client might have but only requires 5 of those nine symptoms to make the diagnosis. In practice, this means a lot of judgment calls.

Most people with Borderline Personality Disorder have some but not all of the “criteria” for the disorder. Gunderson suggests in his book that there are three distinct Levels of Borderline Personality Disorder based on the nature of your relationships with others.

Children experience some mood instability as a normal part of growing up. We expect some BPD characteristics that will go away as they mature. As a result, children are almost never given a personality disorder diagnosis. When the BPD picture seems to be developing, the child may be described as having “Borderline traits.”  Those with untreated BPD generally do not get better with age, the pain they experience grows.

BPD begins in early adulthood and those “characteristics” or “traits” need to occur in multiple situations. This disorder, when treated, generally fades as the person gets older. Women make up 75% of those who get BPD diagnosis and frequently had a diagnosis of Bipolar Disorder prior to being diagnosed with BPD. This disorder is probably underdiagnosed in men because men act out, break laws, and get caught abusing substances more often than women. These other problems get diagnosed first and become the focus of treatment.

Treatment for Borderline Personality Disorder is effective in reducing symptoms. Ten years after treatment half of those diagnosed with BPD no longer have enough symptoms to receive the diagnosis though they may continue to have some Borderline “traits.”

There appear to be a number of Causes of Borderline Personality Disorder. Some of the symptoms of BPD are adaptive behaviors that may have worked to protect you and get your needs met when you were younger but as you grow up these behaviors no longer work.

Abandonment is a key issue for those with BPD. They need someone in their life and can’t stand being alone but fear being rejected and abandoned. They are constantly on the lookout for signs of potential abandonment. As a result, they may appear needy and drive people away. Their impulsive behavior creates exactly what they most fear.

Someone with BPD is very sensitive to their environment. When things do not go well in relationships they blame themselves and may “take it out” on themselves. Self-mutilating, cutting, burning, and suicide attempts are common.

Because of their terrible need for a supportive relationship BPD individuals tend to jump into very close intimate relationships without getting to know the other person. As a result, they over-trust people who should not be trusted and expect more from partners than another person can provide. Once disappointed they become furiously angry. They are often demanding in relationships and need lots of time with their partner. They may have violent emotional reactions when their partner attempts to leave for work, school, or errands.

Sudden changes in their opinions of others are common. When let down by those in their life they respond with lots of anger, sarcasm, and bitterness which only drives others farther away.

Many individuals with BPD report they don’t know who they are other than by adopting the values of those around them. They may have sudden changes or difficulty identifying values, goals, or career plans. They often self-sabotage. It is not uncommon for someone with BPD to quit school just before finals or leave a job just as they were about to get a raise or promotion.

Living with Borderline Personality Disorder is a horrific challenge for those with this condition and it challenges those who would like to be in a relationship with the person with a Borderline condition. While treatment is never easy it can be effective and result in creating a happy, fulfilled, and connected life.

Other posts on Borderline Personality Disorder include:

What is Borderline Personality Disorder?

What causes Borderline Personality Disorder?

Levels or types of Borderline Personality Disorder

Treatment for Borderline Personality Disorder

Staying connected with David Joel Miller

Seven David Joel Miller Books are available now!

My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.

Story Bureau.

Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.

Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.

As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.

Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.

Planned Accidents  The second Arthur Mitchell and Plutus mystery.

Letters from the Dead: The third in the Arthur Mitchell mystery series.

What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?

Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

For videos, see: Counselorssoapbox YouTube Video Channel